Hepatology:他汀再添新作用:降低HBV、HCV肝硬化患者失代偿风险

2017-03-22 MedSci MedSci原创

背景:他汀类药物降低由HCV导致的肝硬化患者功能失代偿及死亡风险。然而,这种收益是否可拓展到普通人群,或者诸如HBV和酒精性肝硬化尚不清除。他汀同样也可降低HBV和HCV感染患者肝细胞癌的发生风险。这种作用是否能够在已经存在肝硬化的患者出现也不清除。我们旨在识别他汀在降低HBV、HCV或酒精性肝硬化患者肝功能失代偿、死亡率的作用。方法:从台湾国家医疗保险受益者中选取肝硬化患者。累积限定日剂量大于等

背景:他汀类药物降低由HCV导致的肝硬化患者功能失代偿及死亡风险。然而,这种收益是否可拓展到普通人群,或者诸如HBV和酒精性肝硬化尚不清楚。他汀同样也可降低HBV和HCV感染患者肝细胞癌的发生风险。这种作用是否能够在已经存在肝硬化的患者出现也不清楚。我们旨在识别他汀在降低HBV、HCV或酒精性肝硬化患者肝功能失代偿、死亡率的作用。

方法:从台湾国家医疗保险受益者中选取肝硬化患者。累积限定日剂量大于等于28者被定义为他汀使用者,作为病例队列纳入研究。通过倾向指数匹配累积限定日剂量小于28者作为非他汀使用者,分析他汀使用和肝功能失代偿、病死率和肝细胞癌发生率之间的关系。

结果:共有1350位肝硬化患者纳入研究,使用他汀降低了肝脏功能失代偿、患者病死率和肝细胞癌发生率,且存在剂量依赖性(P<0.0001,<0.0001和0.009).回归分析显示使用他汀的慢性HBV感染致肝硬化患者肝功能失代偿风险较低(校正风险比(95%置信区间)0.39(0.25-0.62)),HCV感染者亦如此(0.51(0.29-0.93)。在酒精性肝硬化患者中,使用他汀降低的肝功能失代偿风险处于具有统计学差异的临界值(0.69(0.45-1.07))。

结论:在HBV或HCV引起的肝硬化患者中,使用他汀可降低肝功能失代偿的发生率,在酒精性肝硬化患者中,降低的肝功能失代偿风险处于具有统计学差异的临界值。

原始出处:
Fu-Ming Chang,Yen-Po Wang,Hui-Chu Lang,et al.Statins decrease the risk of decompensation in HBV- and HCV-related cirrhosis: A population-based study. Hepatology,20 March 2017, DOI: 10.1002/hep.29172

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    2017-12-22 klivis
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    2017-03-23 ymljack
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    2017-03-23 gwc384
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    2017-03-23 Ljm1998

    好像阿司匹林啊

    0

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    2017-03-22 虈亣靌

    学习了,值得分享!!!

    0

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    2017-03-22 万里江山一孤舟

    学习了

    0

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    2017-03-22 明天会更好!

    学习了,值得分享!

    0

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